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Sanguineous cerebrospinal fluid in recanalized cerebral infarction
Insights
Spontaneous recanalization of blocked cerebral arteries may lead to hemorrhagic infarction. This study found a strong link between artery recanalization and bloody cerebrospinal fluid (CSF) in stroke patients.
Area of Science:
- Neurology
- Cerebrovascular Diseases
- Stroke Pathophysiology
Background:
- Cerebral artery occlusion is a major cause of stroke.
- The development of hemorrhagic infarction following ischemic stroke requires further clarification.
- Spontaneous recanalization is a potential factor influencing stroke outcomes.
Purpose of the Study:
- To investigate the causal relationship between spontaneous recanalization of occluded cerebral arteries and the development of hemorrhagic infarction.
- To determine if recanalization is associated with the presence of blood in cerebrospinal fluid (CSF).
Main Methods:
- A cohort of 15 patients with internal carotid or middle cerebral artery occlusion was studied.
- Consecutive lumbar punctures were performed to analyze cerebrospinal fluid (CSF).
- Follow-up cerebral angiography was conducted to assess arterial recanalization.
Main Results:
- Seven out of 15 patients showed spontaneous recanalization.
- Six of the seven recanalized patients had sanguineous (bloody) CSF on days 2-3 post-ictus.
- Only one of the eight non-recanalized patients had bloody CSF.
Conclusions:
- Spontaneous recanalization of occluded cerebral arteries is strongly associated with the development of hemorrhagic infarction.
- The presence of bloody CSF in the early days after stroke may indicate recanalization and subsequent hemorrhagic transformation.
Abstract:
To clarify the causal relationship between spontaneous recanalization of the occluded cerebral artery and development of hemorrhagic infarction, 15 patients with internal carotid or middle cerebral arterial axis occlusion were submitted to consecutive lumbar punctures and follow-up cerebral angiography. Consequently, six of seven recanalized patients had sanguineous cerebrospinal fluid (CSF) on the second or third day after ictus, while only one of eight non-recanalized patients had bloody CSF. It was strongly suggested that recanalization might have an initimate relationship with the development of hemorrhagic infarction.